Amid the ongoing fallout from Joe Biden’s lackluster debate performance on June 27, experts continue to react to potential signs of cognitive decline in the 46th president, with the president himself acknowledging on Monday morning, July 8, that he had a “terrible night” and “really regrets” that it happened.

Judy Gaman, CEO of Executive Medicine of Texas — a luxury medical services provider in Southlake — told Fox News Digital over the weekend that Biden’s behaviors highlight a very real health crisis in the U.S.

“As a country, we need to be talking about the realities of this health crisis — the fact that families are often torn apart by denial,” she said.

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While Biden has not been diagnosed with dementia, Gaman said she sees many of the same signs she experienced with her own mother, who suffered from Alzheimer’s disease before her death.

“The person with dementia or Alzheimer’s truly believes they are fine, and can be angered by anyone believing they are not,” Gaman said. (She has not examined or treated Biden.)

Fox News Digital reached out to both the White House and the Biden campaign but did not receive a response. 

Red flags

Based on his speech and behaviors, Gaman said she believes Biden “certainly” shows signs of a neurological deficit, with Alzheimer’s being a possibility. 

“He stares, loses his thoughts and is rumored to get angry quite easily,” she said. “Watching him is like watching my own mother who had Alzheimer’s,” she added. 

“As a country, we need to be talking about the realities of this health crisis — the fact that families are often torn apart by denial.”

Almost all early Alzheimer’s patients rely on notes to help them remember, Gaman pointed out.

“As the disease progresses, they require visual aids and instructions to help them complete even the simplest tasks and to remember dates and events.”

Given Biden’s shuffling feet and lack of arm movement when he walks, Gaman said that Parkinson’s disease could be another possibility.

“If you notice, he also leans forward, which is classic,” she said. “Slowed movement, also known as bradykinesia, is another classic sign. We have all noticed how he looks to be in slow motion.”

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Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said it is more likely that Biden has vascular dementia, which is the second most common type of dementia after Alzheimer’s.

“His gait is not consistent with Parkinson’s disease,” Siegel, who has not treated Biden, told Fox News Digital.

“He was visited by a Parkinson’s expert in January 2024, but the subsequent White House physical said he didn’t have it.” 

“I think what he has is much more consistent with vascular dementia.”

Siegel also said he believes Biden is not showing signs of advancing Alzheimer’s, which would generally involve worsening behavioral issues, delusions and hallucinations.

“I don’t believe this is Alzheimer’s,” the doctor added. “I think what he has is much more consistent with vascular dementia (insufficient blood flow to areas of the brain) from his long-term atrial fibrillation and a result of his brain aneurysm repairs in 1988 and brain bleed at that time.”

Vascular dementia is when impaired blood flow to the brain causes problems with memory, reasoning, judgment and other thought processes, according to Mayo Clinic’s website.

It is often caused by strokes, but can also stem from other medical conditions that affect the blood vessels in the brain.

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Most of the cognitive tests — such as the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment — are designed to assess mild cognitive impairment, according to Siegel.

“Biden appears to be far past that,” he said. “I was calling for that from 2020 to 2023.”

Added Siegel, “He needs an MRI now most of all. We should ask for an MRI.”

The dangers of denial

Regarding the Biden family’s apparent failure to seek help for the president, Gaman said that in her view, she feels there are only three explanations.

“Either they are in denial and have watched this take place over a period of time, so they are less sensitive to the contrast, or they are fully aware but can’t bear the thought of what happens to the family (on many levels) if Joe is no longer president,” she said.

Or, Gaman added, it could be that they are actually grieving and want to hold onto the hope that he will somehow get better. 

“Denial is a stage of grief,” she said. “This is worsened by the fact that they’re surrounded by people pressuring them not to let their opponent win.”

“This is a medical situation, though, of course, it has enormous political implications.”

As far as Biden himself, Siegel said, “He does appear to be in denial. This is very common with dementia or cognitive impairment, as is depression, as those around you start to treat you differently.”

Another possibility, according to Gaman, is that “he probably doesn’t know he has an issue, or he excuses his symptoms. He may not be knowingly covering it up.”

“This is why family members of those affected must be advocates, protecting them from themselves.”

She went on, “Ask any family who has dealt with Alzheimer’s, dementia or Parkinson’s, and they will tell you that what we are seeing play out [here] is classic with most families who face this.”

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“His story just happens to be playing out on the big stage. Remember, everyone rallying around Biden and covering up the truth has something personal to gain by him continuing to hold office.”

If Biden is experiencing cognitive decline, failure to get him the medical attention he needs could be putting his health in danger, according to Gaman.

“While there are certainly no cures for Alzheimer’s or Parkinsons, these conditions are often accelerated by stress and lack of sleep,” she told Fox News Digital. 

“From Joe’s health standpoint, this is like pouring gasoline on a fire. From the standpoint of the country, we need to address this as a health crisis and not a political crisis.”

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Gaman also noted that if Biden does have one of these conditions, he will not ask for help. 

“This is a prime opportunity to increase funding for research, raise awareness and encourage others dealing with this to come out of denial.”

Siegel added that he is also concerned about the possibility of depression, which could make dementia worse.

“As a physician, I feel compassion for the president,” he said. “I have learned to feel empathy for anyone who is ill. This is a medical situation, though, of course, it has enormous political implications.”

If Biden does have a neurodegenerative condition, Siegel said, the symptoms may wax and wane, but “do not generally get better.”

He added, “He will likely get worse, especially under all this stress and scrutiny.”